Impetigo

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Impetigo

Impetigo is a disease characterized by the formation of superficial intraepidermal localized vesiculo-pustular lesions. Usually begins with the appearance of painful erythematous papules, transforming through the stage of vesicles into honey-crusted scabs. Etiology. Isolates isolated from lesions in more than 80% of cases are represented by Staphylococcus aureus or its mixed group A rhyemolytic streptococcus. Risk factors

    • Tropical or subtropical climate (warm, humid conditions)
    • Summer or rainy season
    • Minor damage to the skin, insect bites, etc.
    • Poor hygiene conditions, epidemics, wars, etc.
    • The presence of impetigo in the family
    • Poor health due to anemia and malnutrition
    • Impetigo can develop as a complication of head lice, scabies, chickenpox, eczema
    • contact dermatitis.

clinical picture. Lesions may develop slowly or progress rapidly. The primary elements are painful red maculopapular rashes. The latter are transformed into vesicles and then into traditionally painless bullae. After the rupture of the blisters, weeping superficial red ulcers are found, later they are covered with honey-colored crusts. Most often, rashes are found on the face within the mouth and nose or at the site of damage to the skin.

    • bullous impetigo. The main causative agent is Staphylococcus aureus. Lesions progress rapidly from small to large confluent blisters. Lymphadenopathy is not seen
    • Folliculitis. The main causative agent is Staphylococcus aureus. The disease is caused by damage to the hair follicles
    • Ecthyma is a deep ulcerative pyoderma that often occurs with the development of lymphadenopathy.

Research method. Isolation of the pathogen. The material is taken from the bottom of the primary element after the removal of the crust. Both staphylococci and group A streptococci grow on blood agar. Differential diagnosis

    • Chicken pox
    • Herpes
    • erizepeloid
    • Insect bites
    • Severe eczematous dermatitis
    • Scabies
    • Dermatophytosis of the trunk
    • burns
    • Pemphigus vulgaris
    • bullous pemphigoid
    • Stevens-Johnson Syndrome.

Treatment:

Tactics of conducting

    • Removal of crusts, maintaining the cleanliness of the skin by careful washing 2-3 r / day. Personal hygiene to prevent the likely spread of rashes
    • The duration of treatment for the non-bullous form is 7 days (with mild rashes) or 10 days (with widespread rashes); with bullous form – 10 days. Drugs of choice
    • Locally – mupirocin in the form of an ointment (Bactroban) 3 r / day (only for non-bullous form caused by S. aureus and Streptococcus pyogenes). If there is no effect within 3-5 days, antibiotics are additionally prescribed orally.
    • First-generation cephalosporins, such as cephalexin 25–50 mg/kg/day in 4 divided doses (children), 250 mg 4 times a day (adults), or
    • erythromycin (for streptococci) – 0.5 g every 4-6 hours (adults), 30-40 mg / kg / day in 4 divided doses (children under 14 years of age).

alternative products. Amoxicillin 500 mg3 r / day (adults), 125-250 mg 3 r / day (children after 2 years), 20-40 mg / kg / day 3 doses (children under 2 years old).

Complications

    • Ectima
    • Acute glomerulonephritis
    • deep cellulite
    • Sepsis.

Current and forecast. Complete recovery within 7-10 days against the background of ongoing treatment. Antibiotic treatment cannot prevent or stop the development of glomerulonephritis.

Synonyms

    • pyoderma
    • contagious impetigo
    • Common impetigo
    • Fox impetigo ICD. L01 Impetigo